Provider Data Coordinator II

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: Perform day to day functions to inbound requests and maintain provider database. Audit analyses on completed requests and monitor compliance status of submitted requests.

• Analyze inbound request to determine accuracy and route request to provider changes or other cross functional teams
• Maintain provider data management systems for accuracy
• Handle and resolve provider data issues, such as mass change updates, limited reconciliations and direct submissions of urgent requests
• Coordinate provider data between the health plan database and various internal databases
• Participate in reconciliation and provider data projects
• Review, investigate and resolve inquiries regarding loaded providers that may have issues reported from internal and external customers
• Submit daily and weekly internal and external status reports
• Initiate and process provider add, change and termination forms
• Track, update and audit provider information in database
• Assist in Corporate audit activities or requests for claims provider set up

Education/Experience: High school diploma or equivalent. Associate’s degree in related field preferred. 3+ years of provider data or network administration experience, preferably in managed care. Proficient in Microsoft Access and Excel applications. Experience with data management in large databases, reporting, and analysis preferred.

Pay Range: $22.36 - $38.07 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act